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My aunt gifted a large home and 23 acres to her son. She was denied Medicaid. No cash to self pay. Medicaid suggested that son mortgage the property to pay for nursing home. Her other children refused to help pay because they had not been gifted anything. Son ended up selling property and using the money for her care. She was on Medicaid care for 8 years so it would have been a large Medicaid bill.
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Years ago I had a friend who was living in Minnesota or Wisconsin and her Dad gave her $10,000 or so.  A couple of years later when her Dad was admitted to nursing home, the friend had to pay the $10,000 back to her Dad or to someone.  Each state has their own Medicaid rules so you need to talk to a Medicaid/Elder Care attorney about Medicaid in the state that your elderly family member(s) live in.
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A penalty period will be assigned where the recipient will have to self pay for care for as long as the amount equal to the value of the gift is paid. Any money gifted is seen as an attempt to give away funds that should have been used to pay for care. Therefore, those who recieved the funds should now be expected to use those funds to pay for the care needed.
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Medicaid will simply deny coverage for x amount of time that covers the penalty period - they don't actually "go after" gifts. If Medicaid denies paying for nursing home coverage - then someone else will have to pay for the nursing home OR the elder does not live in the nursing home. My sister's MIL is in this situation since she gifted large amounts of money from the sale of her house to her five kids - now Medicaid has denied paying for nursing home for about the equivalent of 40 months. My sister's MIL is currently living with MIL's daughter and the who family is fighting about caring for her - incontinent, combative, needs 24x7 care.

I know of some cases where the elder was made a ward of state (kids could no longer care for parent and did the 911 ER dump - Medicaid had denied coverage due to gifting) and the state pursued repayment of large "gifts" as the entity legally in charge of the elder.

Do you have a specific scenario?
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